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This is a case of an 11-year-old boy who experienced pain and peroneal spastic flatfeet due to the accessory anterolateral talar facet impingement (AATFI). Multiple conservative treatments have been used, but with poor results. Finally, he was referred to our department, and the lidocaine injection test in the sinus tarsi area was used to assist the diagnosis. The patient was effectively treated with subtalar arthroereisis. To our knowledge, using subtalar arthroereisis to treat peroneal spastic rigid flatfoot associated with AATFI has not been previously reported. This method can not only prevent AATFI progression but also correct flatfoot deformity, thus breaking the vicious cycle of AATFI and peroneal spasm from its source. With flatfoot correction, proprioceptive or nociceptive receptors receive normal stimuli, transmit normal proprioceptive signals, and eliminate abnormal reflexes. After a 41-month follow-up period, the clinical outcomes were excellent.